Transcript Introduction to Behavioural Change Lynn Stockley

Introduction to
Behavioural Change
Lynn Stockley
Lynn Stockley & Associates
Summary
• Why you don’t need to be worried.........
• 2 main categories of behaviour change theories/models
– Descriptive
– To bring about change
• Within those, some are intended for using with
individuals, and other with groups or populations
• Using broad principles identified by NICE and GSR is
good practice
• Take control and combine and adapt these theories/models
to suit your purpose.
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PRECEED-PROCEED
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• Darnton A (2008) Behaviour Change: Government Social
Research Knowledge Review. Government Social
Research Advisory Group, London.
http://www.civilservice.gov.uk/Assets/Behaviour%20change
_practical_guide_tcm6-9696.pdf
• National Institute for Health and Clinical Excellence
(2007) Behaviour change at population, community and
individual levels, London.
http://www.nice.org.uk/nicemedia/pdf/PH006quickrefguide.
pdf
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“ tools to be used in the design of
interventions”
“should use models as an aid to
thinking”
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Exercise:-
In pairs
Each of you – share one of your last New
Year’s resolutions (or make one up). With
the help of the other person, try and list all
of the things that influence that behaviour.
Not how to change it – but what influences
it.
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Frameworks, theories and models
• Those that are intended to be descriptive of
influences on behaviour
• Those that identify intervention techniques
to bring about change and/or suggest broad
approaches to intervention design,
implementation and evaluation
Darnton 2008
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Frameworks, theories and models
• Those that are intended to be
descriptive of influences on
behaviour
• Those that identify intervention techniques to bring about change
and/or suggest broad approaches to intervention design,
implementation and evaluation
Darnton 2008
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‘Psychological’ models
Describe influences within and as perceived by
the individual e.g.
• Attitudes e.g. preferences, perceptions of costs,
balance of risks and benefits
• Concepts like self efficacy
• Norms
• Agency
• Habit
• Emotion
• Contextual factors
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Ajzen’s Theory of Planned Behaviour (1986)
Beliefs about
outcomes
Attitude
towards the
behaviour
Evaluation of
outcomes
Relative importance
of attitude and norm
Beliefs about
what others
think
Intention
Subjective
norm
Perceived
Behavioural Control
Reproduced from Conner 2007
Behaviour
‘Societal’ models
• Show behaviour of individuals interacting
with other influences e.g.
• community
• living/working/conditions
• environmental
• cultural
• political
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Dahlgren and Whitehead’s Model of the Main
Determinants of Behaviour
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Reproduced from Watt, R. UCL
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Structuration Theory adapted from Giddens 1984.
Reproduced from Delormier 2009.
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Foresight Obesity Map
Exercise:-
In small groups
Identify a population sub group one of you is
familiar with:Draw the Dahlgren and Whitehead diagram
Fill in the respective elements as far as
possible
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Dahlgren and Whitehead’s Model of the Main
Determinants of Behaviour
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Frameworks, theories and models
•
Those that are intended to be descriptive of influences on behaviour
• Those that identify intervention
techniques to bring about change
and/or suggest broad approaches to
intervention design, implementation
and evaluation
Darnton 2008
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MODEL OF HEALTH PROMOTION 2: HEALTH
PROMOTION METHODS USING BEATTIE’S
TYPOLOGY (BEATTIE – 1991)
MODE OF INTERVENTION
Advice
Education
Legislation
Authoritarian
Behaviour change
Policy making and
implementation
Health surveillance
Mass media campaign
Individual
Group/Popn
Lobbying
Counselling
Action research
Education
Skills sharing and training
Group work
Group work
Negotiated
Community development
.........identify intervention techniques to bring
about change and/or suggest broad
approaches to intervention design,
implementation and evaluation
........................in individuals
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Stages of Change
Reproduced from Watt, R. UCL.
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..........identify intervention techniques to bring
about change and/or suggest broad
approaches to intervention design,
implementation and evaluation
........................in groups or populations
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Is social marketing a behavioural
framework/model/theory......... .......and
does it matter?
• NICE: a mechanism that is successful in some
circumstances:
• GSR: provides step-by-step guidance for developing
interventions. This guidance is consistent with more
specific frameworks e.g. Intervention Mapping (IM)
(for health programmes
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“Social marketing is an adaptable approach, increasingly being
used to achieve and sustain behaviour goals on a range of social
issues.
While formal definitions vary, three key elements commonly
appear:
Its primary aim is to achieve a particular 'social good' (rather
than commercial benefit), with clearly defined behavioural
goals.
It is a systematic process phased to address short, medium and
long-term issues.
It uses a range of marketing techniques and approaches (a
marketing mix......”
http://www.nsmcentre.org.uk/what-is-social-marketing.html
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Social marketing - components
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Social marketing - stages
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“...identify intervention techniques to bring about
change and/or suggest broad approaches to
intervention design, implementation and
evaluation...”
• Darnton 2008 GSR Behaviour Change
review identified 9 principles
• NICE identified 7 principles
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NICE
1. How to plan interventions
2. Assessing the social
context
3. Education and Training
4. For individual level
interventions
5. For Community level
interventions
GSR
1. Identify the audience and
the target behaviour
2. Identify relev behav
(descriptive) models
3. Identify key influences
4. Identify effective
intervention techniques
5. Engage audience
6. Develop prototype
6. For population level
interventions
7. Pilot – with monitoring
7. How to evaluate
9. Feedback
8. Evaluate
What does this mean for me?
• Good practice to use either of the set of
principles
• Behavioural models and theories are tools
not recipes:– get to know your tools. Case studies; metaanalyses interventions and models e.g.
Abrahams and Mitchie
– You control your tools – not the other way
around. Mix, match and adapt.
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Summary
• Why you don’t need to be worried.........
• 2 main categories of behaviour change theories/models
– Descriptive
– To bring about change
• Within those, some are intended for using with
individuals, and other with groups or populations
• Using broad principles identified by NICE and other is
good practice
• Now you’re not worried you can take control and combine
and adapt these theories/models to suit your purpose.
Lynn Stockley & Associates